Should we worry about the eyes of celiac patients?

PURPOSE: In this article, we evaluate subfoveal choroidal thickness in celiac patients with respect to adherence to the gluten-free diet and nonadherence to the gluten-free diet, comparing with age and sex matched healthy controls using spectral-domain optical coherence tomography. MATERIALS AND METHODS: A case-control study among 42 celiac patients and 42 healthy participants was conducted in the Department of Pediatric Gastroenterology. Celiac patients of our policlinics compliant with spectral-domain optical coherence tomography examination enrolled in the study. Celiac patients had been asked verbally about their adherence to gluten-free diet, were evaluated according to negative or positive EmA and anti-TG2 for defining adherence, and were divided into two groups (adherence to gluten-free diet and nonadherence to gluten-free diet). RESULTS: Subfoveal choroidal thickness was thinner in EmA (+) or anti-TG2 (+) eyes than EmA(-) or anti-TG2 (-) eyes in celiac patients, but it was not statistically significant. The mean subfoveal choroidal thickness values in eyes with celiac disease, whose diagnosis time was longer than 60 months, were thinner than shorter group. Longer duration of gluten-free diet was associated with adherence difficulty and thinner choroidal thickness (r = -0.15, p = 0.34). Adherence to gluten-free diet was 88.2% for children below the age of 60 months and 57.1% for children older than 60 months. CONCLUSION: In conclusion, in addition to other extraintestinal manifestations of celiac disease, diagnosis time longer than 60 months in pediatric celiac patients, nonadherence to the gluten-free diet, and antibody positivity should be focused on during ophthalmologic examination and choroid measurement.

Changes in tear film, corneal topography, and refractive status in premenopausal women during menstrual cycle.

PURPOSE: To investigate the changes in a questionnaire based subjective symptomatology, tear film break-up time, tear volume, corneal topography, and refractive status in premenopausal women during menstrual cycle. METHODS: Seventeen premenopausal females and 15 healthy males were enrolled in this prospective study. After routine ophthalmologic examination, an ocular surface disease index questionnaire was administered, tear film break-up time (TBUT), and Schirmer I tests were performed. Keratometry readings and refractive status were also obtained. All examinations were repeated at day 21, day 12 and day 2. RESULTS: OSDI score in day 21 was significantly lower than that in day 12 (p=0.004) and day 2 (p=0.01) in the female patients; however, no significant change was found in the male subjects (p>0.05). No statistically significant difference was found in TBUT and Schirmer I tests, keratometry, and refraction results in both of the female and male subjects at all of the test points (p>0.05). There was a significant correlation between OSDI score and TBUT (p=0.02, p=0.03, respectively), and Schirmer I test at day 12 (p=0.004, p=0.008, respectively). A significant negative correlation was found between oestrogen level and horizontal keratometry values at day 21 (r=-0.5, p=0.03; r=-0.4, p=0.04, respectively) for the right and left eyes in the female subjects. CONCLUSION: Our study confirms that fluctuations in the blood levels of oestrogen produce alterations in ocular surface equilibrium during the menstrual cycle and consequently affect the subjective dry eye symptoms in female patients. However, no ocular surface parameter changes were observed.

Flash electroretinography and pattern visual evoked potential changes in ocular hypertension patients.

Purpose. To evaluate the changes of flash electroretinography (fERG) and pattern visual evoked potentials (pVEP) in ocular hypertension (OHT) patients. Methods. Twenty-five OHT patients and 30 healthy volunteers were enrolled for this cross-sectional study. Opthalmologic examinations, visual field tests, pVEP and fERG were performed. The main outcome measures were the differences between pVEP and fERG parameters. Results. The mean age of OHT patients and volunteers were 57 ± 12.25 years (range 30-65 years), and 53.25 ± 12.0 years (range 30-65 years), respectively. The mean amplitude of the pVEP was statistically lower in the OHT group (P < 0.05). Latency of the two groups was different; however, the difference was not statistically significant (P > 0.05). In fERG of OHT group, there was a significant decrease in the amplitude of the oscillatory potentials (Ops), and a significant delay in latency of rod and cone waves (all P < 0.05). There was no significant change in the flicker fERG waves between the two groups (P > 0.05). Conclusions. Although we found a decrease in Ops amplitude and a prolonged latency in flicker fERG, only the decrease in Ops amplitude was statistically significant between the two groups. The amplitude of Ops wave and amplitude of pVEP may reflect early glaucomatous damage in OHT patients.